Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
  • A61K31/716—Glucans
  • A61K31/718—Starch or degraded starch, e.g. amylose, amylopectin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/08—Solutions
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
  • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
  • A61M1/1654—Dialysates therefor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
  • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
  • A61M1/1654—Dialysates therefor
  • A61M1/1656—Apparatus for preparing dialysates
  • A61M1/1666—Apparatus for preparing dialysates by dissolving solids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
  • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
  • A61M1/287—Dialysates therefor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/02—Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/12—Drugs for disorders of the urinary system of the kidneys
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
  • A61P7/08—Plasma substitutes; Perfusion solutions; Dialytics or haemodialytics; Drugs for electrolytic or acid-base disorders, e.g. hypovolemic shock

Definitions

• the present invention relates to esterified Polysaccharidosmotika, their use, processes for their preparation and compositions containing them.
• Osmotic active compounds are widely used in pharmacy and medicine.
• osmotic agents are used to adjust the tonicity of drugs, especially parenteral drugs.
• the osmotic pressure of a drug is adjusted depending on the type of application hypotonic, hypertonic or isotonic.
• the osmotic pressure of a parenteral drug solution can be adjusted to the osmotic pressure of human blood by adding an osmoticum (isoosmotic solutions).
• osmotic agents are used in dialysis treatment, in particular in peritoneal dialysis, in order to extract excess water from the dialysis patient.
• the peritoneal dialysis method is based on that a solution containing osmotically active compounds is introduced via a catheter into the abdominal cavity of the dialysis patient. This solution is left in the abdominal cavity of the patient for a certain time (usually a few hours), where it develops its osmotic action; i.e. The patient's own body water is withdrawn into the abdominal cavity. After a certain residence time, the now diluted peritoneal dialysis solution is drained via a catheter.
• IPD intermittent
• NIPD nocturnal intermittent
• CCPD continuous cyclic
• CAPD continuous ambulatory peritoneal dialysis
• osmotically active compounds should in particular ensure that the osmotic pressure of the peritoneal dialysis solution is high enough during the entire residence time in the abdominal cavity to draw water from the patient; ie water passes from the patient's circulation into the abdominal cavity (ultrafiltration).
• the direction of water migration may even reverse, i.e., in the direction of water.
• Water passes from the abdominal cavity into the patient's bloodstream (negative ultrafiltration). This is the case when the diluted peritoneal dialysis solution in the abdominal cavity has a lower osmotic pressure than the patient's own water (e.g., blood).
• the osmotic pressure can be maintained over a treatment time suitable for peritoneal dialysis, so that there is no excessive decrease in the ultrafiltration within the residence time of the solution in the abdominal cavity.
• a negative ultrafiltration is largely prevented.
• the solutions employed in peritoneal dialysis treatment typically contain sugar monomers or polymers, such as glucose or polyglucose (e.g., starch derivatives), as osmotically effective compounds.
• EP-B1-0602585 proposes the use of hydroxyethyl starch as an osmotic agent.
• EP-B 1-0083360, EP-B2-01 15911, EP-B 1-0153164 and EP-B 1-0207676 relate to solutions for peritoneal dialysis which contain starch hydrolyzate-glucose polymers as osmotic active compounds.
• the osmotic agents according to the invention are distinguished from conventional osmotic agents in that they have an increased osmotic activity at the same concentration.
• this increased osmotic activity causes the removal of water (ultrafiltration) during the dialysis treatment to be increased and / or maintained for a longer period of time.
• a more effective dehydration occurs in the dialysis treatment. This can for example contribute to shorten the duration of dialysis treatment.
• the concentration of osmoticum of the invention may be reduced to achieve the same osmotic efficacy of a conventional osmotic agent. The shortening of the duration of dialysis treatment and / or the lowering of the concentration can in turn lead to a lower incidence of undesired effects in dialysis patients.
• a first subject of this invention are polysaccharides containing monosaccharide monomers that are at least partially esterified with a dicarboxylic acid and / or tricarboxylic acid for use as an osmotic agent.
• esterification of the polysaccharide with a dicarboxylic acid and / or tricarboxylic acid deprotonatable and thus anionically charged side chains are introduced into the polysaccharide. It has been found that by introducing these deprotonatable or anionic side chains, the efficiency of the peritoneal dialysis treatment is improved by increased ultrafiltration.
• polysaccharide includes compounds containing at least ten monosaccharide monomers (Pure & Applied Chemistry, 1995, 67, 1360).
• the dicarboxylic acid is a physiological dicarboxylic acid and the tricarboxylic acid is a physiological tricarboxylic acid.
• physiological dicarboxylic acid or “physiological tricarboxylic acid” comprises dicarboxylic acids or tricarboxylic acids which occur in human metabolism. Examples include the physiological di- and tricarboxylic acids of the Krebs cycle.
• dicarboxylic acid means an organic compound having two acid groups (carboxyl groups, -COOH) and the term “tricarboxylic acid” for an organic compound having three acid groups.
• the acid groups may be uncharged, ie as -COOH (carboxyl) or anionic, ie deprotonated as -COO " (carboxylate) .
• a cationic counterion eg sodium, potassium).
• calcium, magnesium cation form a salt.
• the dicarboxylic acid is preferably selected from the group consisting of oxalic acid, oxaloacetic acid, ketoglutaric acid, glutamic acid, aspartic acid, fumaric acid, maleic acid, malic acid, malonic acid, succinic acid, glutaric acid, adipic acid, pimelic acid, suberic acid, azelaic acid, sebacic acid.
• the dicarboxylic acid is oxalic acid, glutamic acid, aspartic acid, maleic acid or succinic acid. Especially preferred are maleic acid and succinic acid.
• the tricarboxylic acid is preferably citric acid or isocitric acid, especially citric acid.
• the polysaccharide according to the invention may be composed of the same but also of different monosaccharide monomers.
• the polysaccharide of the invention is composed of the same monosaccharide monomers. Glucose is particularly preferred.
• polysaccharide may also be composed of monosaccharide monomers other than glucose and / or fructose. Typical monosaccharide monomers are known to those skilled in the art.
• the linking of the monosaccharide monomers in the polysaccharide according to the invention is preferably carried out via glycosidic bonds.
• the polysaccharide according to the invention may be cross-linked.
• Typical crosslinking agents are known to the person skilled in the art.
• epichlorohydrin and diisocyanate compounds may be mentioned here. It is particularly preferred that the polysaccharide according to the invention is not cross-linked.
• the average molecular weight of the polysaccharide of the present invention is preferably 2,000 to 30,000 g / mol, more preferably 2,500 to 26,000 g / mol, even more preferably 3,000 to 22,000 g / mol, even more preferably 3500 to 20,000 g / mol, most preferably 4,000 to 18,000 g / mol, and in particular 5000 to 15000 g / mol.
• the average molecular weight of the polysaccharide according to the invention is 15,000 to 25,000 g / mol, in particular 18,000 to 22,000 g / mol.
• the polysaccharide of the present invention preferably has an average degree of polymerization of from 10 to 170, more preferably from 11 to 130, even more preferably from 12 to 100, most preferably from 13 to 80, and especially from 14 to 50.
• the average degree of polymerization of the polysaccharide according to the invention is 80 to 140, more preferably 85 to 135, even more preferably 90 to 130, most preferably 95 to 125 and in particular 100 to 120.
• a 7.5 weight percent aqueous solution of the polysaccharide of the invention has a theoretical osmolarity> 11.9 mosm / L, more preferably greater than> 12.5 mosm / L, even more preferably greater than> 13.0 mosm / L, most preferably greater than > 13.5 mosm / L and in particular greater than> 14.0 mosm / L.
• the term "theoretical osmolarity" means the theoretically calculated osmolarity. Methods for calculating this value are known to the person skilled in the art.
• the co-osmotic pressure of a 7.5% by weight solution of the polysaccharide according to the invention is> 50 mosm / L or> 60 mosm / L, more preferably> 70 mosm L or> 80 mosm / L, even more preferably> 90 mosm / L or> 100 mosm / L, most preferably> 110 mosm / L or> 120 mosm / L and in particular> 130 mosm / L or> 140 mosm / L.
• the co-osmotic pressure of a 7.5% by weight solution of the polysaccharide according to the invention is> 150 mosm / L or> 160 mosm / L, more preferably> 170 mosm / L or> 180 mosm / L, even more preferably> 190 mosm / L or> 200 mosm / L, most preferably> 210 mosm / L or> 220 mosm / L and in particular> 230 mosm / L or> 240 mosm / L.
• the colloid osmotic pressure of a 7.5 weight percent solution of the polysaccharide of the invention is 50 to 500 mosm / L, more preferably 75 mosm / L to 400 mosm / L, even more preferably 100 to 300 mosm / L, most preferably 110 mosm / L L to 275 mosm / L and in particular 120 mosm / L to 250 mosm / L.
• the colloid osmotic pressure of a 7.5% by weight solution of the polysaccharide of the invention is 100 to 500 mosm / L, more preferably 100 mosm / L to 400 mosm / L, even more preferably 100 to 350 mosm / L, most preferably 100 mosm / L L to 325 mosm / L and in particular 100 mosm / L to 290 mosm / L.
• the term "colloid osmotic pressure” means the experimentally measured osmotic pressure of the solution, which is composed of osmotic and oncotic pressure. Suitable methods for the experimental determination of this value are known to the person skilled in the art.
• the osmolality of a 7.5% by weight aqueous solution of the polysaccharide of the present invention is preferably> 16mosm / kg, more preferably> 18mosm / kg, even more preferably> 20mosm / kg, most preferably> 22mosm / kg and especially> 25mosm / kg.
• the term "osmolality" refers to the osmolality of the solution experimentally determined by freezing point depression. Methods for determining the freezing point depression are known to the person skilled in the art.
• the osmolarity of the polysaccharide according to the invention experimentally determined by freezing point depression is preferably> 15 mosm / L, more preferably> 17 mosm / L, even more preferably> 19 mosm / L, most preferably> 21 mosm / L and in particular> 23 mosm / L.
• the polysaccharide according to the invention is esterified with the dicarboxylic acids and / or tricarboxylic acids described above.
• the polysaccharide according to the invention has a degree of substitution of from 0.01 to 3, more preferably from 0.05 to 2.5, even more preferably from 0.1 to 2, most preferably from 0.25 to 1, 5 and in particular from 0.5 to 1 on.
• the polysaccharide of the invention has a degree of substitution of 0.02 ⁇ 0.01 or 0.05 ⁇ 0.025, more preferably 0.1 ⁇ 0.05, even more preferably 0.5 ⁇ 0.25, most preferably 1 ⁇ 0.5 and especially 1.5 ⁇ 0.75.
• the polysaccharide of the invention has a degree of substitution of 0.02 ⁇ 0.005 or 0.05 ⁇ 0.0125, more preferably 0.1 ⁇ 0.025, even more preferably 0.5 ⁇ 0.125, most preferably 1 ⁇ 0, 25 and in particular from 1.5 ⁇ 0.375.
• the polysaccharide according to the invention is preferably suitable as an osmotic agent for adjusting the tonicity of medicaments, in particular of medicament solutions for parenteral administration.
• the polysaccharide according to the invention is used in the dialysis treatment, preferably in the hemodialysis and / or peritoneal dialysis treatment.
• the polysaccharide according to the invention is particularly suitable for use in peritoneal dialysis treatment.
• Another object of this invention relates to a process for the preparation of the polysaccharide according to the invention, comprising the steps
• step a Mixing a polysaccharide with a first organic solvent, b. Mix in step a. obtained dispersion or solution with a dicarboxylic anhydride and / or tricarboxylic anhydride.
• step a used polysaccharide is preferably degraded starch.
• step b The resulting solution or dispersion is added to a catalyst which accelerates the esterification reaction.
• This catalyst is preferably a nucleophilic catalyst, preferably 4- (dimethylamino) pyridine (DMAP).
• DMAP dimethylamino pyridine
• Other analogous catalysts are known in the art.
• base may also be added, preferably an amine base such as triethylamine.
• amine base such as triethylamine.
• Further amine bases are known to the person skilled in the art.
• the catalyst is preferably added in catalytic amounts; i.e. the molar ratio of catalyst (eg DMAP) to acid anhydride is preferably ⁇ 1:10 or ⁇ 1:25, more preferably ⁇ 1:50 or ⁇ 1:75, even more preferably ⁇ 1:75 or ⁇ 1: 100, most preferably ⁇ 1: 250 and in particular ⁇ 1: 500.
• catalyst eg DMAP
• the reaction mixture can be stirred at elevated temperature.
• the temperature is 40 to 80 ° C, more preferably 50 to 70 ° C, still more preferably 55 to 65 ° C, and most preferably 60 ° C.
• the reaction mixture obtained is stirred for 1 to 12 hours, more preferably for 2 to 8 hours, still more preferably for 4 to 6 hours, and especially for 5 hours.
• the molar ratio of acid anhydride to polysaccharide is preferably 0.1 to 5 mol / AGU, more preferably 0.2 to 4 mol AGU, more preferably 0.3 to 3 mol / AGU, most preferably 0.4 to 2 mol / AGU and especially 0 , 5 to 1 mol / AGU.
• the molar ratio is 0.1 to 2.5 mol / AGU, more preferably 0.2 to 1.75 mol / AGU, even more preferably 0.3 to 1.5 mol / AGU, most preferably 0.4 to 1.25 mol / AGU and in particular 0.5 to 0.75 mol / AGU.
• AGU stands for "anhydrous glucose unit” (anhydrous glucose unit). This standard term is known to the person skilled in the art.
• the polysaccharide according to the invention can be separated by precipitation from the solution or dispersion, wherein the precipitation can be induced by addition of a second organic solvent.
• the precipitation preferably takes place in that the polysaccharide according to the invention has a higher solubility in the first organic solvent than in the second organic solvent or the mixture of first and second organic solvents.
• the first organic solvent may be any organic solvent in which the polysaccharide can be dissolved or dispersed.
• the first organic solvent is dimethyl sulfoxide or dimethylacetamide or a mixture thereof. Dimethyl sulfoxide is particularly preferred.
• the second organic solvent may be any organic solvent in which the polysaccharide according to the invention has a lower solubility than in the first organic solvent.
• the second organic solvent is preferably an alcoholic solvent - preferably methanol, ethanol, propanol, isopropanol or butanol - or a ketone solvent - preferably acetone or ethyl methyl ketone.
• Ethanol is especially preferred as the alcoholic solvent.
• Acetone is particularly preferred as the ketone solvent.
• the separation is preferably carried out by filtering the precipitate precipitated.
• the filtered precipitate is preferably dried. This drying step is preferably carried out at elevated temperature (preferably 40 ° C) and at reduced pressure (preferably vacuum).
• the process for the preparation of the polysaccharides according to the invention comprises the following steps:
• the process for producing the polysaccharide according to the invention comprises the following steps:
• a further subject of this invention relates to dialysis solutions comprising at least one polysaccharide according to the invention.
• the dialysis solution according to the invention is a hemodialysis solution or a peritoneal dialysis solution.
• the dialysis solution according to the invention is in particular a peritoneal dialysis solution.
• Dosage forms used in the dialysis treatment are preferably concentrates in multi-component systems or ready-to-use dialysis solutions.
• dialysis solution includes a ready-to-use dosage form for dialysis treatment, i. a liquid preparation which is suitable as such for application.
• the dialysis solution does not have to be diluted before administration and / or mixed with other preparations.
• concentrates which may be in either liquid, semi-solid or solid form, are diluted prior to application with water or aqueous solutions or dissolved in water or aqueous solutions.
• components of a multi-component system must be mixed together before application in order to obtain a ready-to-use dialysis solution. Concentrates and multicomponent systems can therefore be regarded as the precursor of the dialysis solution according to the invention.
• the dialysis solution according to the invention is preferably a hemodialysis or a peritoneal dialysis solution.
• Hemodialysis and peritoneal dialysis solutions usually contain electrolytes in a concentration which essentially corresponds to the plasma electrolyte concentration. Electrolytes usually include sodium, potassium, calcium, magnesium and chloride ions. Dialysis solutions usually have a physiologically acceptable pH. This is preferably achieved by buffers (buffer systems), which themselves can contribute to the total content of electrolytes.
• the buffers are preferably bicarbonate, lactate or pyruvate.
• dialysis solutions usually have a physiologically acceptable osmolarity. This is usually achieved by the electrolytes contained in the dialysis solution and polysaccharides according to the invention, which are physiologically compatible as osmotically active compounds (osmotic agents) in the desired concentration.
• the dialysis solution according to the invention has an osmolarity in the range of preferably 200 to 550 mosm / L.
• the osmolarity is preferably 200 to 350 mosm / L or 210 to 340 mosm / L, more preferably 220 to 330 mosm / L, even more preferably 230 to 320 mosm / L, most preferably 240 to 310 mosm / L and in particular 250 to 300 mosm / L.
• Methods for measuring osmolarity and osmotic pressure are known to those skilled in the art. For example, these can be determined using a membrane osmometer or other suitable measuring methods.
• the osmolarity is preferably 200 to 570 mosm / L or 210 to 560 mosm / L, more preferably 220 to 550 mosm / L, still more preferably 230 to 540 mosm / L, most preferably 240 to 530 mosm / L and in particular 250 to 520 mosm / L.
• the osmolarity is 250 ⁇ 50 mosm / L or 250 ⁇ 45 mosm / L, more preferably 250 ⁇ 35 mosm / L, even more preferably 250 ⁇ 25 mosm / L, most preferably 250 ⁇ 15 mosm / L and especially 250 ⁇ 10 mosm / L.
• the osmolarity is 300 ⁇ 50 mosm / L or 300 ⁇ 45 mosm / L, more preferably 300 ⁇ 35 mosm / L, even more preferably 300 ⁇ 25 mosm / L, most preferably 300 ⁇ 15 mosm / L and especially 300 ⁇ 10 mosm / L.
• the osmolarity is 350 ⁇ 50 mosm / L or 350 ⁇ 45 mosm / L, more preferably 350 ⁇ 35 mosm / L, even more preferably 350 ⁇ 25 mosm / L, most preferably 350 ⁇ 15 mosm / L and especially 300 ⁇ 10 mosm / L.
• the osmolarity is 400 ⁇ 50 mosm / L or 400 ⁇ 45 mosm / L, more preferably 400 ⁇ 35 mosm / L, even more preferably 400 ⁇ 25 mosm / L, most preferably 400 ⁇ 15 mosm / L and especially 300 ⁇ 10 mosm / L.
• the osmolarity is 450 ⁇ 50 mosm / L or 450 ⁇ 45 mosm / L, more preferably 450 ⁇ 35 mosm / L, even more preferably 450 ⁇ 25 mosm / L, most preferably 450 ⁇ 15 mosm / L and especially 450 ⁇ 10 mosm / L.
• the osmolarity is 500 ⁇ 50 mosm / L or 500 ⁇ 45 mosm / L, more preferably 500 ⁇ 35 mosm / L, even more preferably 500 ⁇ 25 mosm / L, most preferably 500 ⁇ 15 mosm / L and especially 500 ⁇ 10 mosm / L.
• the dialysis solution of the invention has a pH of preferably from 4.0 to 8.0, more preferably from 4.2 to 7.5, even more preferably from 4.4 to 6.8, most preferably from 4.6 to 6.0 or 4.8 to 5.5 and especially from 5.0 to 5.2 or 5.0 ⁇ 0.1; measured at room temperature (20 to 23 ° C).
• the pH is 4.8 ⁇ 1, 0 or 4.8 ⁇ 0.8, more preferably 4.8 ⁇ 0.7 or 4.8 ⁇ 0.6, even more preferably 4.8 ⁇ 0.5 or 4.8 ⁇ 0.4, most preferably 4.8 ⁇ 0.3 or 4.8 ⁇ 0.2 and especially 4.8 ⁇ 0.1.
• the pH is 5.0 ⁇ 1.0 or 5.0 ⁇ 0.8, more preferably 5.0 ⁇ 0.7 or 5.0 ⁇ 0.6, even more preferably 5.0 ⁇ 0.5 or 5.0 ⁇ 0.4, most preferably 5.0 ⁇ 0.3 or 5.0 ⁇ 0.2 and especially 5.0 ⁇ 0.1.
• the pH is 5.2 ⁇ 1.0 or 5.2 ⁇ 0.8, more preferably 5.2 ⁇ 0.7 or 5.2 ⁇ 0.6, even more preferably 5.2 ⁇ 0 , 5 or 5.2 ⁇ 0.4, most preferably 5.2 ⁇ 0.3 or 5.2 ⁇ 0.2 and especially 5.2 ⁇ 0.1.
• the pH is 5.5 ⁇ 1.0 or 5.5 ⁇ 0.8, more preferably 5.5 ⁇ 0.7 or 5.5 ⁇ 0.6, even more preferably 5.5 ⁇ 0 , 5 or 5.5 ⁇ 0.4, most preferably 5.5 ⁇ 0.3 or 5.5 ⁇ 0.2 and especially 5.5 ⁇ 0.1.
• the pH is 6.0 ⁇ 1.0 or 6.0 ⁇ 0.8, more preferably 6.0 ⁇ 0.7 or 6.0 ⁇ 0.6, even more preferably 6.0 ⁇ 0.5 or 6.0 ⁇ 0.4, most preferably 6.0 ⁇ 0.3 or 6.0 ⁇ 0.2 and especially 6.0 ⁇ 0.1.
• the pH is 6.5 ⁇ 1.0 or 6.5 ⁇ 0.8, more preferably 6.5 ⁇ 0.7 or 6.5 ⁇ 0.6, even more preferably 6.5 ⁇ 0.5 or 6.5 ⁇ 0.4, most preferably 6.5 ⁇ 0.3 or 6.5 ⁇ 0.2 and especially 6.5 ⁇ 0.1.
• the pH is 7.0 ⁇ 1.0 or 7.0 ⁇ 0.8, more preferably 7.0 ⁇ 0.7 or 7.0 ⁇ 0.6, even more preferably 7.0 ⁇ 0.5 or 7.0 ⁇ 0.4, most preferably 7.0 ⁇ 0.3 or 7.0 ⁇ 0.2 and especially 7.0 ⁇ 0.1.
• the pH is 7.4 ⁇ 1.0 or 7.4 ⁇ 0.8, more preferably 7.4 ⁇ 0.7 or 7.4 ⁇ 0.6, even more preferably 7.4 ⁇ 0.5 or 7, 4 ⁇ 0.4, most preferably 7.4 ⁇ 0.3 or 7.4 ⁇ 0.2 and especially 7.4 ⁇ 0.1.
• the pH is 8.0 ⁇ 1.0 or 8.0 ⁇ 0.8, more preferably 8.0 ⁇ 0.7 or 8.0 ⁇ 0.6, even more preferably 8.0 ⁇ 0.5 or 8.0 ⁇ 0.4, most preferably 8.0 ⁇ 0, 3 or 8.0 ⁇ 0.2 and especially 8.0 ⁇ 0.1.
• the dialysis solution of the invention contains one or more (e.g., two, three, four or five) polysaccharides of the invention; wherein the polysaccharides of the invention are as defined above.
• the dialysis solution of the present invention contains polysaccharide of the present invention in a total concentration of preferably 0.001 mM to 10 M or 0.01 to 1.0 M, more preferably 0.10 to 500 mM, even more preferably 1.0 to 250 mM, most preferably 10 to 100 mM especially 25 to 90 mM.
• the total concentration is 25 ⁇ 24 mM, more preferably 25 ⁇ 20 mM, even more preferably 25 ⁇ 15 mM, most preferably 25 ⁇ 10 mM, and most preferably 25 ⁇ 5 mM.
• the total concentration is 50 ⁇ 25 mM, more preferably 50 ⁇ 20 mM, even more preferably 50 ⁇ 15 mM, most preferably 50 ⁇ 10 mM, and most preferably 50 ⁇ 5 mM.
• the total concentration is 75 ⁇ 25 mM, more preferably 75 ⁇ 20 mM, even more preferably 75 ⁇ 15 mM, most preferably 75 ⁇ 10 mM, and most preferably 75 ⁇ 5 mM.
• the total concentration is 100 ⁇ 25 mM, more preferably 100 ⁇ 20 mM, even more preferably 100 ⁇ 15 mM, most preferably 100 ⁇ 10 mM, and most preferably 100 ⁇ 5 mM.
• the total concentration is 200 ⁇ 25 mM, more preferably 200 ⁇ 20 mM, even more preferably 200 ⁇ 15 mM, most preferably 200 ⁇ 10 mM, and most preferably 200 ⁇ 5 mM.
• the total concentration is preferably calculated by means of the average molecular weight of the polysaccharides according to the invention.
• the dialysis solution of the present invention contains polysaccharide of the present invention in a total mass concentration of preferably from 0.01 g / L to 1.0 kg / L, more preferably from 0.1 to 750 g / L, even more preferably from 1.0 to 500 g / L, most preferably 10 to 250 g / L and in particular from 100 to 200 g / L.
• the Total mass concentration 25 ⁇ 24 g / L, more preferably 25 ⁇ 20 g / L, even more preferably 25 ⁇ 15 g / L, most preferably 25 ⁇ 10 g / L and especially 25 ⁇ 5 g / L.
• the total mass concentration is 50 ⁇ 25 g / L, more preferably 50 ⁇ 20 g / L, even more preferably 50 ⁇ 15 g / L, most preferably 50 ⁇ 10 g / L and especially 50 ⁇ 5 g / L.
• the total mass concentration is 75 ⁇ 25 g / L, more preferably 75 ⁇ 20 g / L, even more preferably 75 ⁇ 15 g / L, most preferably 75 ⁇ 10 g / L, and most preferably 75 ⁇ 5 g / L.
• the total mass concentration is 100 ⁇ 25 g / L, more preferably 100 ⁇ 20 g / L, even more preferably 100 ⁇ 15 g / L, most preferably 100 ⁇ 10 g / L, and most preferably 100 ⁇ 5 g / L.
• the total mass concentration is 200 ⁇ 25 g / L, more preferably 200 ⁇ 20 g / L, even more preferably 200 ⁇ 15 g / L, most preferably 200 ⁇ 10 g / L and especially 200 ⁇ 5 g / L.
• the dialysis solution according to the invention may also contain other osmotically active substances such as glucose, polyglucose, cross-linked glucose or polyglucose, mannitol or glycerol.
• the dialysis solution according to the invention preferably contains one or more electrolytes.
• electrolyte means a substance containing free ions and having electrical conductivity.
• the electrolyte completely dissociates into cations and anions without substantially altering the pH of an aqueous composition. This property distinguishes electrolytes from buffer substances.
• the electrolytes are present in a concentration that results in substantially complete dissociation in water.
• Preferred electrolytes are selected from the group of alkali metals such as Na + and K + and the alkaline earth metals such as Ca 2+ and Mg 2+ .
• a preferred anion is Cl " .
• the dialysis solution according to the invention may contain further anions such as, for example, bicarbonate, dihydrogen phosphate, hydrogen phosphate, phosphate, acetate, lactate and Containing pyruvate;
• these anions are not referred to as electrolytes but as a buffer due to their buffer capacity in the context of this invention.
• the dialysis solution of the invention contains Na t ion.
• the concentration of Na + ions is preferably 10 to 200 mM or 50 to 190 mM, more preferably 100 to 180 mM or 110 to 170 mM, still more preferably 15 to 165 mM or 120 to 160 mM, most preferably 125 to 155 mM and especially 130 to 150 mM.
• the dialysis solution according to the invention contains no Na + ions.
• the dialysis solution according to the invention contains K + ions.
• the concentration of K + ions is preferably 0.10 to 20 mM, more preferably 0.25 to 15 mM, even more preferably 0.50 to 10 mM, most preferably 0.75 to 7.5 mM, and most preferably 1.0 to 5 , 0mM.
• the concentration of K + ions is 1, 0 ⁇ 0.75, 2.0 ⁇ 0.75, 3.0 ⁇ 0.75, 4.0 ⁇ 0.75 or 5.0 ⁇ 0 , 75 mM and especially 1.0 ⁇ 0.50, 2.0 ⁇ 0.50, 3.0 ⁇ 0.50, 4.0 ⁇ 0.50 or 5.0 ⁇ 0.50.
• the dialysis solution according to the invention contains no K + ions.
• the dialysis solution according to the invention contains Ca ions.
• the concentration of Ca ions is preferably 0.1 to 3 mM, more preferably 0.25 to 2.75 mM, still more preferably 0.5 to 2.5 mM, most preferably 0.75 to 2.25 mM, and most preferably 1 to 2mM.
• the concentration of Ca 2+ ions is 0.25, 0.5, 0.75, 1, 1.25, 1, 5, 1, 75 or 2 mM.
• the dialysis solution according to the invention contains no Ca ions.
• the dialysis solution according to the invention contains Mg 2+ ions.
• the concentration of Mg 2+ ions is preferably 0.01 to 1 mM, more preferably 0.05 to 0.75 mM, even more preferably 0.1 to 0.5 mM, most preferably 0.15 to 0.4 mM, and especially 0.2 to 0.3 mM.
• the concentration of Mg 2+ ions is 0.05, 0.075, 0.1, 0.2, 0.25, 0.50 or 0.75 mM.
• the dialysis solution according to the invention contains no Mg 2+ ions.
• the dialysis solution according to the invention contains Cl " ions
• the concentration of Cl " ions is preferably 10 to 300 mM, more preferably 25 to 250 mM, even more preferably 50 to 200 mM, most preferably 75 to 150 mM and especially 80 to 125 mM.
• the concentration of Cl " ions is 100 ⁇ 50 mM, more preferably 100 ⁇ 25 mM, most preferably 100 ⁇ 10 mM and especially 96 ⁇ 4 mM
• the dialysis solution according to the invention contains no Cl " ions.
• the dialysis solution according to the invention preferably contains one or more buffers.
• buffers include lactate, hydrogen carbonate, carbonate, dihydrogen phosphate, hydrogen phosphate, phosphate, pyruvate, citrate, isocitrate, succinate, fumarate, acetate and lactate salts.
• lactate lactate
• hydrogen carbonate carbonate
• carbonate dihydrogen phosphate
• hydrogen phosphate hydrogen phosphate
• phosphate phosphate
• pyruvate citrate
• isocitrate succinate
• fumarate acetate
• lactate salts lactate salts
• the concentrations of cations or anions and the total concentration of ions will be calculated, whether used as part of electrolytes, buffers or other compounds (eg as the salt of the polysaccharides of the invention).
• the buffer contains bicarbonate.
• Hydrogen carbonate is a well-tolerated buffer system which is in an alkaline medium with carbonate and in an acidic medium with H 2 C0 3 or C0 2 in equilibrium.
• other buffer systems can also be used which are in the range of pH 4 to pH 8, more preferably in the range of pH 5 to pH 7.6 and in particular in the range of pH 7.6, 7.4, 7.2 and /.
• the buffer contains the salt of a weak acid, preferably lactate.
• the acid strength (pK s ) of the weak acid is preferably ⁇ 5.
• the buffer may also be a mixture of substances having a buffering action, for example a mixture containing bicarbonate and a salt of a weak acid (eg lactate).
• a low hydrogen carbonate concentration has the advantage that the C0 2 pressure in the container is low.
• the dialysis solution according to the invention is buffered by bicarbonate.
• the hydrogencarbonate concentration is preferably 1.0 to 200 mM, more preferably 2.5 to 150 mM, still more preferably 5 to 100 mM, most preferably 5 to 75 mM or 10 to 50 mM, and most preferably 20 to 30 mM.
• the bicarbonate concentration is 25 mM.
• the dialysis solution according to the invention contains no bicarbonate.
• the dialysis solution according to the invention is buffered by lactate.
• the lactate concentration is preferably 1.0 to 200 mM, more preferably 2.5 to 150 mM, still more preferably 5 to 100 mM, most preferably 10 to 50 mM or 10 to 25 mM, and most preferably 15 mM.
• the dialysis solution according to the invention contains no lactate.
• the dialysis solution according to the invention is buffered by acetate.
• the acetate concentration is preferably 1.0 to 100 mM, more preferably 1.0 to 50 mM, even more preferably 1.0 to 25 mM, most preferably 1.0 to 10 mM or 2.0 to 7.5 mM and especially 2 , 5 to 7.0 mM.
• the dialysis solution according to the invention contains no acetate.
• the total volume of dialysis solution is not limited. Usually, the volume is several liters (suitable administration volume for a patient) to several hundred liters (suitable storage volume for more than one patient).
• the expression "dialysis solution” in the sense of this invention means a ready-to-use dialysis solution, ie the dialysis solution can be used directly for dialysis treatment (hemodialysis or peritoneal dialysis).
• the dialysis solution according to the invention is a peritoneal dialysis solution as described below.
• the peritoneal dialysis solution is biochemically tuned to substantially correct the metabolic acidosis associated with kidney failure.
• the peritoneal dialysis solution preferably contains hydrogencarbonate in approximately physiological concentrations.
• the peritoneal dialysis solution contains bicarbonate in a concentration of about 20 to 30 mM.
• the peritoneal dialysis solution contains a bicarbonate concentration of 25 mM.
• the peritoneal dialysis solution preferably contains carbon dioxide having a partial pressure (pC0 2 ) of less than 60 mmHg.
• pC0 2 of the peritoneal dialysis solution is substantially equal to pC0 2 measured in blood vessels.
• the peritoneal dialysis solution preferably has a pH of about 7.4. Therefore, the peritoneal dialysis solution is a physiologically acceptable solution.
• the peritoneal dialysis solution preferably contains a weak acid with a pK s ⁇ 5.
• the weak acids are preferably compounds that occur as physiological metabolites in glucose metabolism.
• the weak acid is preferably selected from the group consisting of lactate, pyruvate, citrate, isocitrate, ketoglutarate, succinate, fumarate, malate and oxaloacetate. These acids may be contained either alone or as a mixture in the peritoneal dialysis solution.
• the weak acids are preferably contained in a concentration of 10 to 20 mEq / L and substantially as sodium salts in the peritoneal dialysis solution.
• the weak acid is preferably contained in an amount corresponding to the daily metabolic hydrogen production of about 1 mEq / kg / day.
• the peritoneal dialysis solution contains at least one polysaccharide according to the invention as defined above.
• the peritoneal dialysis solution according to the invention preferably contains a concentration of bicarbonate and has a pC0 2 , as measured in healthy, non-renal failure patients.
• the weak acid diffuses along the concentration gradient of the dialysis solution into the blood of the dialysis patient and thus corrects the metabolic acidosis of dialysis patients.
• Another object of this invention relates to multi-component systems for the preparation of ready-to-use dialysis solutions described above.
• the preparation is preferably carried out in a manner described in detail, i. by following a corresponding manual (protocol).
• Said production can be done manually, e.g. by mixing individual components or diluting a component with water.
• production can also be automated, e.g. by means of a device which is suitable for this process and can be commercially available.
• the dressing need not necessarily result in a dialysis solution of static (consistent) composition but may also result in a dialysis solution that continuously changes composition, which change may be monitored by a suitable device.
• the polysaccharide of the present invention may be contained in a dialysis solution which is continuously diluted during the dialysis treatment so that the patient is exposed to a decreasing polysaccharide concentration.
• the dialysis solutions of the invention are suitable for use in the treatment of renal insufficiency.
• the dialysis solutions according to the invention are suitable for use in the dialysis treatment.
• the dialysis solutions according to the invention are suitable for use in the hemodialysis and / or peritoneal dialysis treatment.
• Another object of this invention relates to a kit which is configured for the preparation of the dialysis solutions according to the invention, wherein the kit
• the preparation of the dialysis solution according to the invention by mixing the first component with the second component and optionally the / the further component (s) takes place.
• the kit comprises at least a first component and a second component.
• the kit may also include other components, e.g. a third and a fourth component.
• the kit consists of two components, which are preferably different from each other.
• the term "component” includes liquid, semi-solid or solid compositions which may be the same or different from each other, whereby the ready-to-use dialysis solution according to the invention is obtained by mixing all components of the kit.
• a single component contains a portion of the ingredients contained in the ready-to-use dialysis solution.
• the first and second components may be, independently of each other, solid, semi-solid or liquid.
• the components may be solutions or dispersions (e.g., dispersions or suspensions).
• the first component is liquid, preferably pure water or an aqueous solution
• the second component is also liquid.
• the first component is liquid, preferably pure water or an aqueous solution
• the second component is solid, preferably a pulverulent mixture.
• the first component is preferably a solution containing osmotically active substances (eg polysaccharide according to the invention), calcium ions, magnesium ions, hydronium ions and chloride ions.
• the kit according to the invention can be designed in various ways.
• the individual components may be present in separate containers (eg individual bags).
• the kit according to the invention is preferably a container, such as a multi-chamber container system (eg flexible or rigid multi-chamber container system), preferably a flexible multi-chamber bag system.
• the kit according to the invention is preferably a multi-chamber container system which contains the first component, the second component and possibly one or more further components in chambers, which are separated from one another by releasable or breakable separation systems (eg separating breaker parts) Component, the second component and optionally the one or more other components after dissolving or breaking the separation system can be mixed together to obtain the dialysis solution according to the invention.
• releasable or breakable separation systems eg separating breaker parts
• the multi-compartment container may be in the form of plastic containers (e.g., multi-compartment plastic bags), each containing a separate compartment for each component.
• the plastic container contains the individual component solutions in chambers, which are separated from each other by separating elements.
• the multi-chamber container is preferably a two-chamber bag comprising a plastic container having a first chamber and a second chamber, wherein the chambers are separated by a separable system, and the first chamber contains the first component and the second chamber contains the second component.
• the breaking or breaking of the separation system leads to the mixing of the two components and results in the ready-to-use dialysis solution.
• the first chamber and the second chamber are preferably arranged adjacent in the container and separated from each other by the separation system.
• the separation system is preferably a separating seam (eg detachable or breakable weld seam).
• the separating seam preferably opens by the application of a Pressure on one of the chambers, whereupon the separation seam breaks or dissolves and mixes the contents of the two chambers and the mixture can be used as a ready-dialysis solution in the dialysis treatment.
• the first component of the kit of the invention is preferably a sterile solution containing an acid and having a pH of ⁇ 6.0; the second component is preferably also a sterile solution, which preferably contains a buffer and has a pH> 7.0.
• the polysaccharide according to the invention may be present in the first component or in the second component as well as in both components in equal or different concentrations. In a preferred embodiment, the polysaccharide of the invention is contained only in the first (acidic) component.
• the polysaccharide according to the invention is contained only in the second (basic) component.
• the first component and / or the second component and / or the optionally further component (s) may contain one or more electrolytes but also buffers.
• mixing of the individual components usually results in a dilution effect in the event that the components contain the ingredients in different concentrations.
• the polysaccharide of the present invention is contained solely in one of the components, mixing this component with at least one other component will result in an increase in volume relative to the amount of polysaccharide present in the invention, and thus dilution, i. Decrease in polysaccharide concentration; consequently, the component preferably contains the polysaccharide according to the invention in a higher concentration than the ready-to-use dialysis solution.
• the concentration of polysaccharide of the invention in the component is close to the saturation concentration at a temperature of 5 ° C to ensure sufficient storage stability at higher temperatures.
• the total mass concentration of polysaccharide of the invention in the component is 0.01 g / L to 1.0 kg / L, more preferably 0.1 to 750 g / L, even more preferably 1.0 to 500 g / L, most preferably 10 to 250 g / L and in particular 100 to 200 g / L.
• the total mass concentration of polysaccharide according to the invention in component 25 is ⁇
• the total mass concentration of polysaccharide according to the invention in the component 50 is ⁇
• the total mass concentration of polysaccharide of the invention in the component is 75 ⁇ 25 g / L, more preferably 75 ⁇ 20 g / L, even more preferably 75 ⁇ 15 g / L, most preferably 75 ⁇ 10 g / L and especially 75 ⁇ 5 g / L.
• the total mass concentration of polysaccharide of the invention in the component is 100 ⁇ 25 g / L, more preferably 100 ⁇ 20 g / L, even more preferably 100 ⁇ 15 g / L, most preferably 100 ⁇ 10 g / L and especially 100 ⁇ 5 g / L.
• the total mass concentration of polysaccharide of the invention in the component is 200 ⁇ 25 g / L, more preferably 200 ⁇ 20 g / L, even more preferably 200 ⁇ 15 g / L, most preferably 200 ⁇ 10 g / L and especially 200 ⁇ 5 g / L.
• the second component comprises the total amount of polysaccharide of the invention and a suitable buffer which increases the pH of the second component to above 7.0, more preferably to above 7.5, even more preferably to above 8.0, most preferably above 8.5 and in particular to above 9.0.
• a suitable buffer which increases the pH of the second component to above 7.0, more preferably to above 7.5, even more preferably to above 8.0, most preferably above 8.5 and in particular to above 9.0.
• This can preferably be achieved by hydrogencarbonate, which may be present, for example, in the form of dissociated sodium bicarbonate and / or potassium bicarbonate.
• the second component is solid and comprises a pulverulent mixture comprising at least one polysaccharide according to the invention and at least one buffer, for example sodium and / or potassium bicarbonate.
• the multi-compartment bag is preferably suitable for the preparation of a dialysis solution which can be used for use in the peritoneal dialysis treatment and preferably contains the following ingredients in the following concentration
• one chamber of the multi-chamber bag system contains a first acidic concentrate and another chamber contains a second basic concentrate; wherein the acidic concentrate comprises Ca ions and but the basic concentrate HCO 3 0 ions does not contain Ca 2® ions; and the two concentrates can be mixed together after dissolving or breaking the separation system (eg, cut seam); wherein the mixing of the two concentrates results in the preparation of the ready-to-use dialysis solution and the pH of the ready-to-use dialysis solution is 7.0 to 7.6.
• the basic concentrate contains at least one polysaccharide according to the invention and optionally glucose and / or polyglucose
• the acidic concentrate contains no polysaccharide according to the invention and no glucose and / or polyglucose.
• the basic concentrate contains an amount of bicarbonate that results in a bicarbonate concentration of the ready to use dialysis solution of at least 20 mM.
• the bicarbonate concentration of the basic component is so high that the ready-to-use dialysis solution has a bicarbonate concentration of 25 mM.
• the pH of the basic, buffered second concentrate is preferably adjusted with hydrochloric acid.
• the two concentrates are in a volume ratio of 10: 1 to 1:10 or 8: 1 to 1: 8, more preferably 5: 1 to 1: 5 or 3: 1 to 1: 3, more preferably 2: 1 to 1: 2 and in particular 1: 1 mixed together.
• the multi-chamber bag preferably has a gas barrier film which prevents gaseous CO 2 from escaping from the system. Gas barrier films are known in the art.
• a preferred object of this invention relates to a method for producing a dialysis solution, wherein the desired mixing ratio is effected automatically by a dialysis machine or a peritoneal dialysis cycler.
• the invention relates to a solid composition suitable for preparing the dialysis solution of the invention by dissolving it in a defined volume of a solvent (e.g., water).
• a solvent e.g., water
• the solid composition is a component described above and thus a component of the kit according to the invention.
• the solid composition contains the polysaccharide of the invention in any solid form, e.g. as powder, granules, pellets, etc.
• the polysaccharide according to the invention may be present as lyophilisate or spray-dried.
• the solid composition of the invention preferably contains a bicarbonate salt such as sodium or potassium bicarbonate.
• the molar ratio of bicarbonate to polysaccharide of the invention in the solid composition is preferably 1: 100 to 100: 1, more preferably 1:50 to 50: 1, even more preferably 1:25 to 25: 1, most preferably 1:10 to 10: 1 and in particular 1: 5 to 5: 1.
• the defined volume of solvent needed to prepare the dialysis solution of the present invention by dissolving the solid composition is preferably 1.0 to 2,000.
• the solvent is purified water, sterilized water or water for injections, optionally one or more of the above described electrolytes, one or more osmotically active substances (eg at least one polysaccharide according to the invention) and / or one or more of the buffers described above.
• a further subject of this invention relates to the use of at least one polysaccharide according to the invention for the preparation of the dialysis solution according to the invention (hemodialysis solution or peritoneal dialysis solution).
• a further subject of this invention relates to the use of a kit according to the invention for the production of the dialysis solution according to the invention (hemodialysis solution or peritoneal dialysis solution).
• a further subject of this invention relates to the use of a solid composition according to the invention for the production of the dialysis solution according to the invention (hemodialysis solution or peritoneal dialysis solution).
• the resulting starch maleates of the present invention exhibit increased osmolality (as determined experimentally by freezing point depression) and greatly increased colloid osmotic pressure and ultrafiltration compared to the non-substituted degraded starch at the same concentration.
• the volume increase of the filling volume of the tube was determined, which reflects the osmotic effect of the agent.
• the osmotic agents used were 2 starch maleates according to the present invention and the established osmotic agents glucose and icodextrin.
• the starch maleates used in the experiment have the following structural formula:
• the 2 starch maleates differ in the degree of substitution (DS).
• Starch maleate 1 has a degree of substitution of 0.1.
• Starch maleate 2 has a degree of substitution of 0.5.
• FIG. 3 The results are shown in FIG. 3 as a diagram.
• the starch maleates show a significantly greater osmotic activity against glucose after a period of more than 4 hours, and a slightly lower osmotic activity than icodextrin.

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